COVID-19 Cases are Extremely High

The more people an individual interacts with, and the longer that interaction lasts, the higher the risk of COVID-19 spread. Location can be a factor, too, with outdoor activities generally being less risky than indoor activities. The risk of COVID-19 spread increases as follows:

Lowest risk: Meetings and other activities are conducted virtually. Only essential activities (i.e., provision of essential services) occur in person.

More risk: Small, in-person gatherings like board meetings or support groups are held. Outdoor activities and meetings are prioritized. Individuals from different households remain spaced at least 6 feet apart and do not share objects. No food is served at meetings or events. Most staff telework and if staff or stakeholders are present in a facility, they are required to wear masks (if able) and maintain social distancing. Rigorous cleaning and disinfecting practices are implemented. Attendees at the organization’s meeting and events come from the same local geographic area (e.g., community, town, city, county).

Higher risk: Indoor activities are held. Medium-sized in-person gatherings are adapted to allow individuals to remain spaced at least 6 feet apart. In CBO facilities, common areas are closed, and staff are encouraged to wear masks (if able) and maintain social distancing. Food is served in pre-packaged boxes with disposable utensils to eliminate the need for shared items or congregating around serving tables. For meetings and events, a limited number of attendees come from outside the local geographic area.

Highest risk: Standard operations and programming are resumed. Large in-person gatherings are held where it is difficult for individuals to remain spaced at least 6 feet apart. Food is served “potluck” or family style. Many event attendees come from outside the local geographic area.

The virus that causes COVID-19 is mostly spread by respiratory droplets released when people cough, sneeze, or talk. Someone can also get COVID-19 by touching a surface or object that has the virus on it and then touching their own nose, mouth, or possibly their eyes. Therefore, personal prevention practices (such as staying home when sick, social distancing, wearing a mask, and handwashing) and environmental prevention practices (such as cleaning and disinfection) are important ways to prevent the spread of COVID-19.

These prevention principles are covered in this document. They provide CBOs with actions to help lower the risk of COVID-19 exposure and spread during sponsored activities.

Continue to take these steps to reduce your risk of getting and spreading COVID-19:

• Correctly and consistently wear a mask that completely covers your nose and mouth
• Stay at least 6 feet away from others who do not live with you
• Avoid crowds
• Avoid poorly ventilated indoor spaces
• Stay home when you are sick
• Wash your hands frequently with soap and water for at least 20 seconds (or use hand sanitizer containing at least 60% alcohol)
• Get vaccinated when the vaccine is available to you
• Get tested if you have signs or symptoms of COVID-19, or if you think you may have been exposed to someone with COVID-19

Even if you and others (including children) do not feel sick and do not have any symptoms, you can still spread COVID-19 to family, friends, and community.

Do NOT be around others if you have been exposed to someone with COVID-19, if you are sick, or if you have tested positive for COVID-19.

CBOs should consider implementing strategies to encourage behaviors that reduce the spread of COVID-19.

• Staying Home when Appropriate 
  • Educate staff and stakeholders about when they should stay home and when it is safe to gather in person with other people for work or group activities.
    • Develop policies that encourage sick employees to stay at home without fear of reprisal, and ensure employees are aware of these policies.
    • Actively encourage stakeholders who are sick to stay home.
    • Staff and stakeholders should stay home if they have tested positive for or are showing COVID-19 symptoms.
    • Staff and stakeholders who have recently had close contact with a person with symptoms of or diagnosed with COVID-19 should also stay home and monitor their health.
    • CDC’s criteria can help inform people when it is safe to gather with others:
      • If they have been sick with COVID-19
      • If they tested positive for COVID-19 but had no symptoms
      • If they have recently had a close contact with a person with COVID-19
• Hand Hygiene and Respiratory Etiquette 
  • Require frequent employee handwashing with soap and water for at least 20 seconds and increase monitoring to ensure adherence.
  • If soap and water are not readily available, hand sanitizer that contains at least 60% alcohol can be used; rub hands together until dry.
  • Encourage staff to cover coughs and sneezes with a tissue. Used tissues should be thrown in the trash and hands washed immediately with soap and water for at least 20 seconds.
  • Encourage alternate forms of greeting besides handshakes, hugs, and kissing. For example, introduce a new practice of waving or bowing.
  • Encourage clients and others coming to your office or attending events to engage in these same practices.
• Masks  
  • Require the use of masks among staff and volunteers, as feasible. Masks are most essential in times when social distancing is difficult. Information should be provided to all staff and volunteers on proper use, removal, and washing of masks.
    • Note: Masks should not be placed on:
      • Babies or children younger than 2 years old
      • Anyone who has trouble breathing
      • Anyone who is unconscious, incapacitated, or otherwise unable to remove the mask without assistance
    • Masks are meant to protect other people in case the wearer may have the virus and not know it. Masks are not meant to be a substitute for personal protective equipment such as surgical masks, respirators, or other medical personal protective equipment.
    • Encourage clients and other stakeholders coming to your facility or attending events to bring and use masks. 
• Adequate Supplies
  • Ensure you have accessible sinks and enough supplies available for staff, facility visitors, and attendees to clean their hands and cover their coughs and sneezes at all events. Supplies include soap, water, a way to dry hands (e.g., paper towels, hand dryer), tissues, hand sanitizer containing at least 60% alcohol, disinfectant wipes, masks (as feasible), and no-touch/foot pedal trash cans (preferably covered).
• Signs and Messages 
  • Post signs in highly visible locations (e.g., at building entrances, in restrooms) that promote everyday protective measures and describe how to stop the spreadpdf icon of germs by properly washing handsand properly wearing a maskimage icon.
  • Use the preferred language(s) of staff and stakeholders for signs and messages.
  • Consider developing signs and messages in alternative formats (e.g., large print, Braille, American Sign Language) for people who have low vision or are blind or people who are deaf or hard of hearing.
  • At events, broadcast regular announcements on reducing the spread of COVID-19 on PA system
  • Include messages (for example, videos) about behaviors that prevent spread of COVID-19 when communicating with staff, volunteers, and others who may be in your facility, attend your events, or receive your services.
  • Find freely available CDC print and digital resources on CDC’s COVID-19 communications main page.

CBOs should consider implementing strategies to maintain healthy operations.

• Regulatory Awareness
  • Be aware of local or state regulatory agency policies related to group gatherings to determine if events can be held.
• Participation in Community Response Efforts
  • Consider participating with local authorities in broader COVID-19 community response efforts (e.g., sitting on community response committees) and collaborating with other CBOs to coordinate activities or limit duplication of efforts, where possible.
  • Inform local authorities about areas of concern or previously unknown issues as well as community or organizational resources that might be helpful in responding to changing circumstances in the community.
• Flexible and Responsive Operations and Communication Plans
  • Define roles, responsibilities, and decision-making protocols so that the organization can adjust operations, services, and programming in response to changing community conditions.
  • Develop a communication plan to alert stakeholders to changes in operations and ensure that contact information is up to date.
  • Develop information-sharing systems with partners, including local health officials.
• Designated COVID-19 Point of Contact
  • Designate a staff person to be responsible for responding to COVID-19 concerns. All staff and stakeholders should know who this person is and how to contact them.
• Protections for Staff and Others who are at Higher Risk of Severe Illness from COVID-19
  • Offer options that limit exposure risk (e.g., telework, modified job responsibilities) for staff at higher risk for severe illness (including older adults and people of all ages with certain underlying medical conditions).
  • As feasible, offer options that limit the COVID-19 exposure risk (e.g., virtual attendance) for stakeholders who are at higher risk for severe illness. Replace in-person meetings with video- or tele-conference calls whenever possible.
  • Limit event attendance to staff and attendees who live in the local geographic area (e.g., community, city, town, county) to reduce risk of spread from areas with higher levels of COVID-19.
  • Put in place policies that protect the privacy of people at higher risk for severe illness regarding their underlying medical conditions.
• Social Distancing and Modifying Layouts 
  • Reconfigure office spaces, waiting or meeting rooms, break rooms, conference rooms, or similar areas to allow for at least 6 feet between people.
  • In situations where people will form lines, encourage people to stay at least 6 feet apart by providing signs or other visual cues such as tape or chalk marks.
  • Limit attendance at events to allow for social distancing, or host smaller events in larger rooms.
  • Prioritize outdoor activities where attendees can remain at least 6 feet from others not living in their household.
  • If distributing items like food or supplies, consider using drive-up distribution so that people can maintain distance from each other and to eliminate the need to touch doorknobs and other items and surfaces in a facility.
  • Consider temporarily suspending singing, chanting, or shouting during events especially when participants are in close proximity to each other. If attendees choose to sing, chant, or shout, encourage them to wear masks and increase distance between people to greater than 6 feet.
• Meetings, Gatherings, and Performances 
  • Pursue virtual group events, gatherings, or meetings, if possible, and promote social distancing of at least 6 feet between people if in-person events are held. Limit group size to the extent possible.
  • Prioritize outdoor activities where attendees can remain at least 6 feet from others not living in their household.
  • When planning events, consult CDC’s Considerations for Gatherings and Community Events.
  • Limit any nonessential visitors, spectators, and volunteers at events.
  • Limit activities involving external groups or organizations as much as possible – especially with individuals not from the local geographic area (e.g., community, town, city, or county).
  • Consider temporarily suspending musical performances that involve singing or playing wind instruments. If such events are held, musicians should be spaced as far apart as feasible, ideally farther than 6 feet apart.
• Childcare and Youth Programming
  • If providing a nursery or childcare during meetings or events, refer to CDC’s information on preventing the spread of COVID-19 in childcare settings.
  • If holding summer day camps, refer to CDC’s information on youth and summer camps.
• Identifying Small Groups and Keeping Them Together (Cohorting)
  • Ensure that groupings of staff, volunteers, and program participants are as small and as static as possible. CBOs should consider:
    • Scheduling staff and volunteers together in small groups (cohorts) so that they are always scheduled to work on the same days/times together, reducing their exposure risk.
    • Ensuring attendees of regular events (e.g., support groups) are scheduled with the same group of attendees for each event so that individuals are in contact with the same people for each visit, and so that distinct groupings do not mix.
    • Limit use of supplies and equipment to one group of people at a time and clean and disinfect between use.
• Staggered Scheduling
  • Stagger arrival times or locations for meetings and events.
  • Use flexible worksites (e.g., telework) and flexible work hours (e.g., staggered shifts) to help establish policies and practices for social distancing of at least 6 feet between employees, volunteers, and others.
• Transportation
  • For employees who commute to work using public transportation or ride sharing, encourage them to use transportation options that minimize close contact with others (e.g., walking or biking, driving or riding by car – alone or with household members only) or consider offering the following support:
    • Ask employees to follow the CDC guidance on how to Protect Yourself When Using Transportation, including public transit.
    • Allow employees to shift their hours so they can commute during less busy times.
    • Ask employees to maintain social distance when possible, wear a mask if able, and wash their hands as soon as possible when they arrive to work.
  • Where possible, avoid activities that require shared transportation vehicles.
  • If using shared transportation vehicles like vans or buses, clean and disinfect them according to the guidance for bus transit operators or drivers for hire. Ensure that drivers and passengers wear masks, if they are able; remain about 6 feet apart, as feasible; and wash their hands as soon as possible after the trip.
• Communication Systems
  • Put systems in place to:
    • Encourage staff and stakeholders who come to your facility or attend events sponsored by your organization to self-report to the designated COVID-19 point of contact if they have symptoms of COVID-19, a positive test for COVID-19, or were exposed to someone with COVID-19 within the last 14 days in accordance with health information sharing regulations for COVID-19external icon (e.g., see “Notify Health Officials and Close Contacts” in the Preparing for When Someone Gets Sick section below), and other applicable privacy and confidentiality laws and regulations.
    • Notify staff and stakeholders of cancellations and restrictions in place to limit exposure to COVID-19 (e.g., limited hours of operation).
    • Identify and address potential language, cultural, and environmental barriers associated with communicating COVID-19 information to organization staff and stakeholders. Tailor information so that it is easily understood by various audiences and is available in a variety of languages and formats.
    • Learn more about reaching people of diverse languages and cultures by visiting: Know Your Audience. You can also, learn more about communicating to staff in a crisis at Crisis Communications.
• Leave (Time Off) Policies
  • Implement flexible sick leave policies and practices that are not punitive and that enable employees to stay home when they are sick, have been exposed to someone with COVID-19, are caring for someone who is sick, or who must stay home with children if schools or childcare centers are closed.
    • Examine and revise policies for leave, telework, and employee compensation as needed.
    • Ensure employees are aware of these policies.
• Back-Up Staffing Plan
  • Monitor absenteeism of employees and critical volunteers, cross-train staff and volunteers, and create a roster of trained back-up staff and volunteers.
  • Develop policies for employees and volunteers to return to their duties and the facility after having COVID-19. CDC’s criteria to discontinue home isolation and quarantine can inform these policies.
• Staff Training
  • Train staff on all safety protocols. Use CDC’s Interim Guidance for Businesses and Employers as a guide.
  • Conduct training virtually or ensure that participants maintain social distancing during training.
  • As volunteers often perform important duties, consider similar monitoring, planning, and training for them.
  • Consider that volunteer and staffing levels may need to increase to implement cleaning and safety protocols.
• Close Contact
  • CBO staff or volunteers who have close contact (within 6 feet) with clients (e.g., people who visit client homes) should take extra precautions. CBOs should consult with local public health officials and occupational safety and health professionals to decide whether staff or volunteers should wear any form of personal protective equipment rather than or in addition to a mask. Masks offer some protection to the wearer and are also meant to protect those around the wearer, in case they are infected with the virus that causes COVID-19. Masks are not meant to be a substitute for personal protective equipment such as surgical masks, respirators, or other medical personal protective equipment.
  • Limit the amount of time staff or volunteers are in close contact (within 6 feet) with others, to the extent feasible.
  • Maintain a supply of masks for clients to wear (if able) and provide guidance on how to wear them properly.
  • Remind clients to cover their mouth and nose with tissues when coughing or sneezing. Used tissues should be thrown in the trash and hands washed immediately with soap and water for at least 20 seconds.
  • Proper hand hygiene is an important infection control measure. Ensure employees and volunteers wash their hands regularly with soap and water for at least 20 seconds. If soap and water are not readily available, provide an alcohol-based hand sanitizer containing at least 60% alcohol. Key times to clean hands in general include:
    • Before, during, and after preparing food
    • Before eating food
    • After using the toilet
    • After blowing your nose, coughing, or sneezing
    • Before entering a client’s home and upon leaving
    • After touching frequently touched surfaces
    • After putting on, touching, or removing masks
  • Employees and volunteers should avoid touching their eyes, nose, and mouth with unwashed hands.
• Recognize Signs and Symptoms 
  • If feasible, conduct daily health checks (e.g., temperature screening and/or symptom checking) of staff, volunteers, and others who come to your facility or attend your events safely and respectfully, and in accordance with any applicable privacy laws and regulations.
  • CBOs should consider using examples of screening methods in CDC’s General Business FAQs as a guide.
• Sharing Facilities  
  • Encourage any organizations that share or use your facility to also follow these considerations. Limit shared facility use, if possible.
• Support Coping and Resilience
  • Promote employees’ ability to eat healthy foods, exercise, get enough sleep, and find time to unwind.
  • Encourage employees and others to talk with people they trust about their concerns and how they are feeling.
  • Consider posting signs for the national distress hotline: call or text 1-800-985-5990; the National Domestic Violence Hotline: 1-800-799-7233 and TTY 1-800-787-3224; and the National Suicide Prevention Lifeline: 1-800-273-TALK (8255).